Battles begin to turn into long war on tuberculosis

THE HAGUE, The Netherlands – It kills millions of people and is carried by a quarter of the man. Yet, there has been only a handful of new drugs for decades and the only vaccine is 100 years old.

Tuberculosis, a curable and preventable lung infection, killed more than 1.6 million people last year – almost as much as HIV / AIDS and malaria combined – and is the world's deadliest infectious disease.

But despite the know-how needed to treat it and even the cost of eradicating it, global efforts to rid humanity of one of its oldest diseases are still lagging behind other public health.

"Tuberculosis kills millions of people for thousands of years and it is a slowly evolving disease.You can get infected and never get sick, or be sick for decades," he said. Ann Ginsberg, Senior Technical Advisor at IAVI. benefit that works on TB.

"You do not see it, even when you get it, you have a cough, fever, night sweats.This is not spectacular."

According to the World Health Organization, 10 million people have contracted TB in 2017 and global infection rates, even though they are falling, remain stubbornly high.

But this year has been marked by several advances, including the testing of a new vaccine and a pill that is incredibly successful against drug-resistant forms of the bacterium, which experts say is optimistic .

More than 3,000 scientists, activists and survivors of the disease gathered this week in The Hague for an annual conference on respiratory health, dominated by advances in the fight against tuberculosis.

Several countries, including South Africa and Belarus, have shown that a new drug, bedaquiline, has always been effective in patients with drug-resistant tuberculosis – sometimes curing 80% of cases.

Adrian Thomas, vice president of global public health at Johnson & Johnson, which holds the bedaquiline patent, said the drug could revolutionize the treatment of tuberculosis.

"It means you do not have the cost of injectables, you do not have the administration, which must be done by a health professional, and you do not have the toxicity but you get the benefits in terms of mortality, "he told Agence France-Presse.

Previously, people with MDR-TB had to undergo a series of painful injections lasting 8 months, often several times a day, with serious side effects, including hearing loss in about half of the patients. .

"At the end of this process, they often said that it would be easier to die than to take drugs," Thomas said.

In anticipation of a WHO recommendation that multidrug-resistant patients should receive bedaquiline, this year Johnson & Johnson has lowered its price to $ 400 (350 euros) per treatment.

For Sharonann Lynch, HIV and TB Policy Advisor at Doctors Without Borders, it's still too high. His organization wants bedaquiline to cost $ 1 a day, half the current price.

"They say they are losing money, but a third of the cost goes to funding the strengthening of the health system," she said.

"Why should sick people in the world need to pay for health system strengthening – this should be the responsibility of governments."

Thomas explained that because of the way it is funded and distributed, most people with access to bedaquiline who need it do not pay for the treatment themselves.

Hope of vaccine

Despite its mortality, there is more than one single vaccine widely used against tuberculosis for almost 100 years. But that too can change.

Last month, drug giant GlaxoSmithKline unveiled a study of an effective new vaccine in 54% of trial participants.

It is subject to reservations (the trial concerned only people from three African countries already suffering from tuberculosis, but was not yet sick) and is in its infancy, but Ginsberg described it as a " turning ".

Marie-Ange Demoitie, who leads the vaccine development for GSK, said the ultimate goal would be to give it to all people of a certain age in areas where TB is prevalent.

"There are several vaccine candidates at the moment but it's the first time we see a positive signal in a population of adult subjects," she told Agence France-Presse. "It's really a breakthrough and brings a lot of hope in the field of TB vaccine."

& # 39; TB is not sexy & # 39;

Last month, UN member states held their first-ever TB summit and pledged billions of dollars to fight the disease. They aim to eradicate it 15 years from now.

The WHO estimates that TB costs the global economy more than $ 20 billion a year, nearly half of which is for the treatment of patients.

Ginsberg asked why we did not spend more to prevent the disease.

"The development of a vaccine costs about $ 1 billion over 20 years, so the investment required is only a small fraction of our annual expenditures," she said.

For Kitty van Weezenbeek, executive director of The Hague-based KNCV Tuberculosis Foundation, tuberculosis has been wrongly neglected in favor of more serious diseases.

"Tuberculosis does not bother anyone, there is nothing sexy about it," she said.

"Ten times the funding for research is going to HIV, I'm not saying it should not go there, the fact is it should also affect TB." – Rappler.com